Use the Assignment 1 Instructions (PDF included in this module) for creating a cloud-based data collection form. CDC and HCUPnet offer you a real glimpse into databases that are currently available for use. They will provide first-hand examples of what data is being collected and how you might develop your form. Examples of demographics you may want to consider: Gender, Age Group, Marital Status, Household Size (including adults, infants, and children of all ages), Race/Ethnicity, Highest Completed Education, Current Employment Status, Gross Income before taxes, Type of Housing (Own/Rent), Urban/Rural, Internet Access The form should include a variety of response options for the seven survey items including date, short answer, paragraph, multiple choice, checkboxes, dropdown list, and scale.

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